Meeting the unmet need for family planning: now is the time

摘要

The rebirth of family planning is well underway and could not be more important or timely, as countries worldwide work towards implementation of international human rights agreements and achievement of the Millennium Development Goals.12 However, as reported in The Lancet by Alkema and colleagues3 and, in this issue, by Jacqueline Darroch and Susheela Singh,4 unmet need for modern contraception in the world's poorest countries is still unacceptably high. Meeting this need will not only help individuals and couples to gain the right to contraceptive information and services,2 but will also improve the health of women, children, and families. The Lancet Series on family planning in 2012 provided compelling evidence for these assertions. Ahmed and colleagues5 estimated that contraceptive use averted 272 040 maternal deaths in 2008, and that meeting unmet need for contraception could prevent an additional 104000 deaths per year. This estimate of an additional 29% reduction in maternal deaths was nearly identical to that made by Cleland and colleagues6 (30%), who also provided evidence for non-contraceptive benefits to women's health and improvements in perinatal outcomes and child survival, mainly by lengthening of interpregnancy intervals. Ezeh and colleagues7 emphasised the effect of meeting the unmet need for contraception on the achievement of global development goals: most of the poorest countries, and particularly those in sub-Saharan Africa, are experiencing rapid population growth (more than 2% per year) with related social, economic, and environmental pressures. Furthermore, the economic